Absence management: Handling 'problem' absence
Section 6 of the Personnel Today Management Resources one stop guide to absence management, covering: how to initiate formal action on 'problem' absence; investigating absence records; initiating absence counselling; and handling long-term absence. Other sections.
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In the previous sections, we have identified the standard absence policies and procedures that should be in place in all organisations as the bedrock for managing absence effectively. These ensure there is a consistent basis for handling absence across the organisation, and that common procedures are in place for handling all absence. Alongside this, we have also discussed that it is possible to put in place a range of positive organisational initiatives to help optimise attendance levels.
For most organisations, the key issue in reducing absence levels is the effective management of 'problem' absence - that is, absence which, whether legitimate or not, is causing significant operational or people management difficulties. This will generally comprise either persistent short-term absence or, in some cases, problematic long-term absence.
The first requirement is a clear definition of the point at which formal action will be triggered. This will normally be defined in terms both of a total number of days in a given period - whether taken in a single period of absence or in multiple instances - and the number of instances of absence in a given period.
Typically, for example, the triggers might be any 10-12 days or any three instances of absence in a rolling 12-month period. A related approach is to use a formula that combines both elements - the most widely used is the 'Bradford Factor', devised by the University of Bradford, which uses the equation below.
The Bradford factor
The Bradford factor places greater emphasis on the number of instances of absence, rather than the total days off. For example, a single spell of absence lasting five days would produce a Bradford factor score of only five, whereas if the individual were to take five separate days off in the same period, this would produce a Bradford factor score of 125.
The underlying logic is that a single spell of absence in a defined period, even if relatively long, is more likely to be attributable to some unavoidable cause, such as an isolated illness or injury.
Conversely, multiple spells of absence are more likely to be indicative of some potential issue or problem - either because the absence is not legitimate or because there is some underlying medical or other factor.
However calculated, the defined trigger points indicate the stage at which employees can normally expect that some formal action should be taken. It should be stressed that this does not automatically legitimise absence below the trigger points. The organisation should make clear that action might be taken at an earlier point if there is apparent cause for concern - for example, if there appears to be any significant pattern of absence or if there is any substantive reason to suspect that the absence is not legitimate.
To take an extreme example, if an employer had clear evidence that an employee was engaged in some inappropriate activity during a period when they were supposedly absent through sickness, then it might be appropriate to initiate formal disciplinary procedures, even though the individual's absence record would not normally have triggered action.
Similarly, if an employee has persistently been absent to levels close to but not exceeding the trigger points, it might be appropriate to initiate at least a formal discussion with the individual to assess whether there is some underlying cause or whether any preventative action can be taken to reduce the absence levels.
Clearly, there is also a risk that some employees will try to 'play the system' by taking unjustified absence below the trigger points. It is important therefore that the organisation demonstrates that recurrent absence has been noted, and that its potential causes are being reviewed.
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Bradford factor points = (Spells of absence)2 x Number of days absent |
Once absence levels have reached the defined trigger points, then it is essential that some formal action is taken in all cases.
It may be tempting for managers to disregard such problem cases, particularly if they already have some knowledge of the circumstances surrounding the particular case. Personal medical or similar conditions can often be highly sensitive, and managers may be reluctant to intrude further, believing that the absence is explained by their knowledge of the condition.
This is understandable, but can easily become converted into an apparent 'licence' for absence, creating greater difficulty in addressing subsequent cases. It is important, therefore, that the trigger point is treated as an absolute - once it is reached, employees should know that some kind of formal action will be taken.
Different circumstances
The nature and extent of the action will, of course, depend on the precise circumstances of each case. As always, the extreme cases are the most straightforward. If there is strong evidence the recurrent absence is not justified, then it is likely that an initial formal interview may progress relatively quickly into the formal disciplinary procedures.
Conversely, if it is known that a long-term absentee is suffering from some well-understood medical condition with a clear prognosis, then it is possible that little immediate action is required.
In such cases, it will generally be appropriate to visit the individual and to seek advice from an organisational occupational health adviser and/or the individual's own GP, to ensure the situation is accurately understood.
In practice, though, most cases will present less clearly defined characteristics. Recurrent short-term absence may, for example, be the result of some underlying medical condition that is genuine but potentially treatable, or which could be improved by a change in lifestyle or diet. Equally, such absence may reflect factors that are potentially controllable - for example, injuries caused by intensive or dangerous sports.
Employees may be suffering from stress-related illnesses, which may in turn stem from domestic or work pressures, or some combination of the two. An employee who regularly takes Mondays off because of hangovers may simply be irresponsible or may have a serious alcohol problem.
In each of these cases, it may not be easy to disentangle 'legitimate' from 'illegitimate' absence, or to decide whether or not the absence is 'avoidable'.
Long-term absence is generally more clear-cut, but even here questions may arise. The employee may not be suffering from a single medical condition, but from a combination of conditions, some of which may be more treatable than others. It may be that, while some aspects of the condition are physical, there is also a psychological or psychosomatic element that is also affecting the individual's capacity to return to work. It may simply be that the nature of the condition or the likely prognosis is unclear. In all these cases, careful investigation and judgement will be needed to ensure that the employee is treated appropriately and fairly.
As these examples illustrate, there is no single course of action that will address all these potential areas. In responding to each case, therefore, the first step will generally be to gather as much data as possible about the individuals' absence record. Typical questions might include:
How many times has the individual been absent over the past 12 months? Does this appear to be broadly typical of the individual's absence record in the past, or have absence levels increased significantly?
What proportion of the individual's absence is certificated? Again, is this typical of the individual's past record?
What are the stated reasons for the individual's absence? Are the reasons broadly consistent, and if so are they potentially indicative of some underlying or recurrent condition? If not, does there appear to be any pattern in the reasons given?
What additional information, if any, has been gathered from previous return-to-work interviews? Has the individual's recurrent absence been discussed previously, and if so what conclusions were drawn?
Is there any other discernable pattern to the absence - for example, absence apparently linked to weekends or holidays, or apparently related to any particular work patterns?
Is there any other evidence about possible causes of absence?
It should be stressed that this kind of questioning is purely exploratory at this stage. Managers should avoid making unwarranted assumptions on the basis of limited evidence, particularly if they are aware of anecdotal or hearsay information about the causes of absence. While it may be legitimate initially to take account of all evidence, it should be treated with appropriate caution and should be used only to help identify potential issues to be discussed with the employee during absence counselling.
The aim at this stage is simply to ensure that the characteristics of the case are understood as fully as possible so that it is possible to engage in a meaningful discussion with the employee.
On the basis of the information gathered in the initial investigation, the manager should then hold a formal meeting with the employee. This is not a disciplinary interview, and no assumptions are made at this stage about the legitimacy or otherwise of the individual's absence record. The intention here is simply to explore the reasons for the individual's past absence, with the aim of identifying any appropriate means of improving attendance levels in the future.
Discussion topics
The content and format of the interview will depend to a large degree on the nature and severity of the absence issues being addressed. However, in broad terms, the discussion can be expected to cover the following topics:
An initial confirmation that the purpose of the meeting is to have a constructive discussion of the individual's absence record. It should be emphasised at this stage that the interview does not form part of the disciplinary procedure, and that there is no assumption that the absence is unjustified
A summary of the individual's absence record, highlighting any significant patterns or characteristics, and a reminder of the operational and staffing difficulties that absence inevitably causes
A relatively open-ended discussion of the causes of the absence. This should focus not only on the most recent incidents, but also on the absence record over a period. The employee should be encouraged to talk openly about the reasons for the absence. If necessary, it may be helpful to indicate that, if the employee acknowledges that past absence was taken for inappropriate reasons, such as to deal with personal or domestic issues, no action will be taken at this stage. The aim should be to obtain a full and honest account so that it is possible to take meaningful action to prevent a recurrence. Similarly, it may be useful to encourage the employee to talk more broadly about their domestic or working life to help identify any factors that might be additional contributors to absence - such as any workplace stresses that, although not directly causing absence, might contribute to an overall reluctance to attend work.
Effective absence counselling requires some skill and sensitivity on the part of the manager, and it may be appropriate to provide training in this field to managers with substantial people management responsibilities. Effective counselling normally displays a number of characteristics including:
A willingness to approach the discussion with an open mind and without fixed assumptions or judgements. In many cases, of course, the manager will begin the discussion with at least some hypotheses about the nature and causes of the absence, drawn from the available evidence - for example, that the absence appears broadly to be genuine or otherwise, or that there are particular causal factors. However, it is essential that the manager responds sensitively to the discussion with a willingness to address any unexpected issues that might arise
The ability to engage in a broad and discursive discussion, without undue direction or control. It may be that the employee is uncomfortable with discussing personal issues, or that they are not fully aware of some of the causal factors affecting attendance - for example, if there are underlying problems with stress or the individual's own psychological state that have not been fully recognised. In such cases, some time may be needed before the real core of the discussion is reached. If the discussion is overly formal or cut short, then the real causes may easily be missed
Good listening skills and a non-judgemental approach. While the discussion should certainly reinforce the key principles of the organisation's absence policy, the starting point should be a supportive and constructive discussion of the employee's issues and needs. If the tone of the discussion is accusatory or critical, it is likely the employees will simply conceal any 'non-legitimate' or potentially unacceptable reasons for absence. This might include significant personal issues, such as care responsibilities or travel problems, as well as work-related factors, such as stress or workload difficulties. It is better that such issues are acknowledged and constructively addressed where possible. It is also important that the manager listens carefully and sensitively to what is being said across the discussion as a whole without jumping to immediate conclusions. It is not uncommon to find that, in situations where the employee feels uncomfortable in acknowledging the real causes of absence, key issues may be alluded to apparently only in passing or obliquely. A skilful counsellor will pick up on these cues and either try to probe further, if appropriate, or note that more expert input may be needed
Awareness of and sensitivity to the underlying implications of issues raised by the employee. While it is generally not possible or desirable for the manager to apply expert skills to the diagnosis of, say, underlying medical or psychological issues, it is helpful to be aware of symptoms or characteristics that indicate problems that the employee may not recognise or acknowledge. It might be that the employee is suffering from a significant alcohol or other addiction problem, or that there is some relatively serious psychological condition, such as clinical depression, underpinning his or her behaviour. The manager will not normally be in a position to diagnose such a condition, but should have sufficient awareness to recognise when an expert referral might be appropriate. It is helpful therefore for managers to have at least a basic awareness of the potential characteristics of conditions such as depression or addiction.
Initial responsibility
It is important that line managers take initial responsibility for conducting absence discussions, with the focus on trying to resolve the operational and practical difficulties caused by high levels of non-attendance. In many cases, the absence counselling session will be sufficient to identify potential causes of absence that can be addressed between the manager and employee.
If this is the case - or if it appears there are no significant factors affecting the individual's absence - then the outcome of the discussion should be a commitment by the employee to an improved absence record in the future. This should include a clear statement by the manager that failure to achieve this is likely to lead to further formal action.
At the same time, if there are any reasonable practical steps that the manager can take to assist or support the individual, then these should also be agreed. It might be that an employee who has domestic or carer responsibilities that have caused attendance problems might be assisted by a relatively minor change in working hours or arrangements. It could also be that stress issues can be addressed by changes in workload or working practices.
It is important that such changes are not seen as legitimising unjustified absence or as unfairly advantaging an employee who has had a poor attendance record. Nevertheless, it is reasonable that, in exchange for the employee's formal commitment to improved attendance, the employer should provide some practical support where appropriate.
Seeking expert advice
Although it will be straightforward to resolve many cases, if there are any concerns about the nature or cause of the absence, then it may well be necessary to seek more specialist advice. This is particularly important if there appears to be any underlying medical or psychological cause for the absence, or if there is uncertainty about the genuineness of the stated reasons for absence. The starting point should be consultation with an HR specialist, but it may well also be appropriate to seek advice from a professional occupational health (OH) adviser.
The availability of reliable OH advice is a major contributor to effective absence management. While only larger organisations will generally be in a position to have an OH adviser on the payroll, most organisations will be able to obtain this kind of expertise on a retained or contract basis.
The role of the OH adviser is to provide independent objective advice on the interpretation of the available evidence about the nature and causes of an individual's absence.
Although it will not generally be possible for the OH adviser to provide a definitive diagnosis - since they will not have access to the individual's health records - they should be able to advise on, for example, the consistency or credibility of medical explanations that have been provided.
It may also be possible for the adviser to identify underlying medical factors that have not been recognised by the individual. Most importantly, the adviser should be able to recommend when additional information is required - for example, by obtaining the employee's permission to approach their GP - or when more specialist advice should be sought. The OH adviser should also be able to provide guidance on appropriate sources of specialist help.
Because the adviser will be able to provide only a limited diagnosis, if there are significant concerns about the individual's medical condition, then it is advisable to seek their permission to obtain a GP's medical report.
It is also good practice to seek a report from the GP before taking any formal disciplinary action in respect of absence levels. This is in part to ensure that, in taking any action, you have behaved reasonably as an employer based on a full understanding of the circumstances of the case. This would be critical if, for example, the employee were subsequently dismissed as a result of the disciplinary action. By gaining as full an understanding of the case as possible, you are more likely to identify the responses likely to address the problem.
Nevertheless, it should be stressed that however much information and advice is available, the handling of 'problem' absence will often be a judgement call. The circumstances will often be complex and multi-faceted, and advisers, including the individual's own GP, will often be reluctant to offer any definitive judgement about whether a given level of absence is justified.
In such circumstances, the only option is to weigh up all the available evidence, and to ensure any resulting judgement is both reasonable and fully explained to the employee involved.
Taking appropriate action
The potential outcomes from absence counselling are highly varied. At its simplest, as indicated above, the session may result in a straightforward commitment by the employee to improve absence levels, based on a clear understanding of the likely consequences if attendance does not improve.
At the opposite extreme, there may be instances - where evidence emerges that the absence is not justified or reasonable - when it is appropriate to move directly into formal disciplinary procedures. In general, formal disciplinary action will be the last resort, invoked only when other attempted solutions have proved ineffective.
More commonly, it will be appropriate to explore with the individual any potential support or actions that are likely to improve their attendance. These might include:
Specific medical support or advice. Treating underlying medical conditions, for example, changing diet or lifestyle, or taking preventative steps. The employer would not normally expect to cover the costs of providing such support (except through existing medical insurance arrangements), although some employers provide support particularly in more extreme cases, such as addiction
Support to address factors that might be contributing to absence levels. For example, stress related to finance or other domestic problems. Help might range from provision of debt counselling or other financial advice, advice on various forms of domestic or carer support, or simple financial loans
Agreement on lifestyle changes likely to improve attendance. This might cover areas such as reducing sports-related injuries, or even leading a less hectic social life. It is reasonable for the employer to seek some commitment in these areas if there is evidence that they are significantly affecting the individual's ability to attend work
Changes in the nature of the individual's role or work activities. If, for example, the individual seems to be suffering from stress related to workload, responsibilities or the physical nature of the work, then consideration should be given to reasonable steps to address these
Changes in the individual's working hours, patterns or location. Particularly if there is evidence that the employee has significant difficulties travelling to work. Although such issues may not be easy to resolve without the individual changing roles, in some cases, relatively minor changes in work arrangements can substantially alleviate attendance problems - for instance, a change in start times may allow easier access to public transport without causing any operational difficulties.
It is critical that any proposed changes are part of a clear and reciprocal agreement between the employer and the employee. If, for example, the employer is taking steps to address specific employee needs in areas such as working hours or practices, there should be a clear statement that in return the employers expect a significant and specified improvement in attendance.
Set targets and timescales for improvement, with a clear statement that failure to achieve these will lead to further formal action, including the possibility of disciplinary action. Also, incorporate other requirements - for example, to produce medical certificates for all absence or for periodic examinations for the OH adviser.
The handling of long-term absence generally raises different issues from those involved in the management of recurrent short-term absence, though the process can be equally sensitive and problematic.
In practice, there is generally little doubt about the legitimacy of long-term absence, although there may be questions about when and how the individual may reasonably be expected to return to work.
In extreme cases, the length of the absence may also cast doubt on the individual's continuing employment - the legal implications of terminating an employee's contract on the basis of incapacity are considered in Section 8 .
Return to work
In most cases, the employer's aim will be to facilitate the individual's return to work at the earliest reasonable opportunity. Even though the individual's condition is likely to be genuine, there may well be steps that can be taken both to alleviate the condition and to smooth the individual's return to work. It is worth bearing in mind that, for an individual who has been absent for a long period, the process of returning to work may be almost as problematic as the illness or injury itself.
As with shorter periods of absence, the first step is to ensure there is a full understanding of the situation, and that regular contact is maintained with the employee. If it is clear early on that the absence is likely to be relatively long - for example, in the case of a major injury or an operation with an extended recuperation period - it is helpful to agree a schedule of contact.
This helps to ensure contact is sustained, while minimising the risk that the contact will be perceived as intrusive. It may, for example, be appropriate to agree a weekly telephone conversation during the early stages of the absence, providing a mechanism for the employer to check whether the condition is progressing as expected and for the employee to raise any issues or concerns.
Closer to the expected point of return, it may then be appropriate for the employer to make one or more home visits, to begin to explore with the individual how the return to work will be managed.
The handling of long-term absence, including reintroduction into the workplace, has tended not be given priority by UK employers, even though long-term absence frequently accounts for a significant proportion of total time lost through absence.
Effective rehabilitation
Nevertheless, effective rehabilitation processes can substantially improve the ease and speed of an employee's return to work. Elements of effective rehabilitation may include:
Medical examinations and reports by occupational health advisers, with appropriate input from the individual's own GP by agreement. It is often helpful to have an expert assessment of the implications of the individual's condition and any likely implications in respect of returning to work - for example, any required limitations on working hours or activities
Some form of phased return that enables the individual to adjust gradually to the demands of work - for example, initially working reduced hours or on a constrained range of tasks. This may be particularly important if, for example, the individual's role involves some form of physical activity. It may be possible for the employee to return to undertake the non-physical aspects of the role even though they are not yet fully fit to undertake all activities. Again, expert advice should be sought about what elements of the role may be suitable
Some permanent modification to the employee's former activities. If the employee is unlikely to be fit to undertake the full range of tasks in the foreseeable future, it may still be possible to revise the role requirements to facilitate a return to work. Clearly, some judgement may be required to assess what is a reasonable level of modification, depending on both the nature of the role and the potential alternatives available to the employer - it may be more difficult for a smaller employer to offer appropriate modifications or alternatives to the role. Some relatively small changes, such as the removal of some physical tasks or a reduction in the level of travel required, may be sufficient to enable a full return to work
Provision of special equipment to assist the individual in carrying out their work. Again, in many cases, the provision of aid in areas such as physical activity, computer use and so on, may be sufficient to enable the individual to carry out their role effectively. This may be required only on a short-term basis, to facilitate the return to work, or as a permanent support
Providing or funding medical support to help alleviate the individual's condition or to prevent conditions becoming chronic - in areas such as physiotherapy
Allowing paid absence to attend medical or similar appointments following the individual's return to work
Changing the individual's work location or providing assistance with travel to work. This might also include setting up arrangements to enable work from home, on either a temporary or permanent basis. It is not uncommon, particularly where the individual has suffered some form of injury or undergone a serious operation, to be fully capable of carrying out their work but still unable to make the required journey into work.
These kinds of rehabilitation activity can be initiated in respect of any long-term absence, though most organisations operate some form of trigger point, typically after four to six weeks' absence, at which rehabilitation is considered.
Any rehabilitation programme needs to be designed around the needs of the individual drawing on whichever of the aforementioned provisions are available.
Once the trigger point has been reached, the manager will consult with the employee, and the relevant HR and OH advisers to agree an appropriate course of action. This will reflect the individual's condition, likely duration of absence, personal requirements, and any other relevant factors.
It should be noted that, as well as bringing potentially substantial benefits in terms of reducing long-term absence, an effective rehabilitation policy also helps ensure compliance with the provisions of the Disability Discrimination Act, by enabling the employer to explore all reasonable routes to support the individual's continued employment. This is discussed in Section 8 .
Long-term absence: termination of employment?
In the vast majority of cases of long-term absence, the employer's aim will be to provide support to the individual and to facilitate their return to work at the earliest reasonable opportunity.
In extreme cases, when the employee's absence has become significantly extended, the employer may have to consider the consequences for the individual's continuing employment. The legal aspects of absence management are considered in more detail in Section 8 .
However, in broad terms, in reviewing the potential employment implications of long-term absence, the key consideration will normally be the individual's 'capability', assessed in terms of their skill, aptitude, health or any other relevant physical or mental factor, in relation to the kinds of activity that might reasonably be expected under their contract of employment.
When considering whether termination of employment is justified, the employer should look at two areas. First, how well the individual was able to carry out the activities prior to their absence. And second, whether suitable alternative employment can be identified that the employee would be capable of undertaking.
It is also critical that, in reviewing cases of long-term absence, the employer appropriately balances the needs of the organisation against considerations of the employee's position, approaching the issue with suitable sympathy and understanding.
It is not possible to give a definitive view as to when termination of employment would be considered 'reasonable'. In considering such a case, an employment tribunal would normally take into account all the circumstances of the case, including factors such as the size and nature of the employer, the individual's condition and prognosis for recovery, the possible availability of suitable alternative employment, the operational impact of the employee's continuing absence, and so on.
The employer will also normally need to demonstrate that a thorough investigation has been carried out into the nature of the individual's illness and the practical likelihood of their returning to work.
In all cases, if there is a perceived risk that employment might be terminated on grounds of capability, this possibility should be communicated to the employee at the earliest opportunity, with a clear statement of the nature and level of the risk if absence continues.
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One government agency attached nurses who were training in occupational health services to work closely with a number of offices where absence levels appeared to be particularly high. The nurses played a number of roles, including conducting case conferences with managers to identify the most appropriate responses to 'problem' absence cases, as well as providing expert support and advice in responding to medical issues. Where appropriate, the nurses also accompanied
managers in conducting absence counselling and return-to-work interviews,
enabling medical issues to be addressed immediately. The result was a
significant reduction in absence levels across all the offices
involved. |
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A large public sector body, which had suffered from high levels of long-term absence over a number of years, set up a national team of experienced HR practitioners to review all cases of long-term sickness absence that had exceeded defined trigger points. The aim of the team was to apply a common set of standards and policies with the aim of resolving all cases, either through return to work within defined timescales or through some form of employment termination. Each case was reviewed, initially with the relevant manager and then with support and advice from an occupational health adviser, with further information being sought from the individuals' own medical advisers where appropriate. On this basis, the team identified the available options and the likelihood of the individual returning to work within a reasonable timescale. Where it was felt that the individual was likely to be able to return to work, then clear timescales were established, and procedures were put in place, in consultation with the employee, to facilitate the return. Where the individual was unlikely to be able to return to work in a reasonable timescale, then the organisation identified the available options - typically either termination of employment on grounds of incapacity or, where possible, early retirement on grounds of ill-health. The team then ensured that appropriate procedures were followed to ensure that the individuals involved were treated consistently and reasonably.
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Section two: Do we have a problem? Section three: What causes employee absence? Section four: Developing an absence policy Section five: Establishing absence procedures Section six: Handling 'problem' absence Section seven: Developing positive initiatives Section eight: Legal implications
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